title: Bringing testing to the people - benefits of mobile unit HIV/syphilis testing in Lima, Peru, 2007-2009.
abstract: Mobile unit (MU) HIV testing is an alternative method of providing healthcare access. We compared demographic and behavioural characteristics, HIV testing history and HIV prevalence between participants seeking testing at a MU vs. fixed clinic (FC) in Lima, Peru. Our analysis included men and transgender women (TW) in Lima aged ≥ 18 years old seeking HIV testing at their first visit to a community-based MU or FC from October 2007 to November 2009. HIV testing history, HIV serostatus and behavioural characteristics were analysed. A large percentage of MU attendees self-identified as transgender (13%) or heterosexual (41%). MU attendees were more likely to engage in transactional sex (24% MU vs. 10% FC, p < 0.001), use alcohol/drugs during their last sexual encounter (24% MU vs. 20% FC, p < 0.01) and/or be a first-time HIV tester (48% MU vs. 41% FC, p < 0.001). MU HIV prevalence was 9% overall and 5% among first-time testers (49% in TW and 11% in men who have sex with men [MSM] first-time testers). MU testing reached large numbers of at-risk (MSM/TW) populations engaged in unsafe sexual behaviours, making MU outreach a worthy complement to FC testing. Investigation into whether MU attendees would otherwise access HIV testing is warranted to determine the impact of MU testing.
authors.affiliation: South American Program in HIV Prevention Research (SAPHIR), University of California at Los Angeles David Geffen School of Medicine, Los Angeles, CA, USA.
authors.forename: Mindy C
authors.initials: MC
authors.lastname: Lipsitz
authors.forename: Eddy R
authors.initials: ER
authors.lastname: Segura
authors.forename: José Luis
authors.initials: JL
authors.lastname: Castro
authors.forename: Edward
authors.initials: E
authors.lastname: Smith
authors.forename: Carlos
authors.initials: C
authors.lastname: Medrano
authors.forename: Jesse L
authors.initials: JL
authors.lastname: Clark
authors.forename: Jordan E
authors.initials: JE
authors.lastname: Lake
authors.forename: Robinson
authors.initials: R
authors.lastname: Cabello
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008952:Mobile Health Units / Q000458:organization & administration / Q000706:statistics & numerical data*; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D012959:Socioeconomic Factors; D013587:Syphilis / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
keywords: AIDS; HIV; HIV prevention techniques; MSM; Peru; alternative HIV testing strategies; diagnosis; men who have sex with men; mobile unit testing; sexually transmitted infection; transgender women